ISOLATED FALLOPIAN TUBE ENDOMETRIOSIS: A CLINICO-PATHOLOGICAL STUDY FROM A TERTIARY CARE CENTRE

Background: Endometriosis is a chronic oestrogen-induced condition in which endometrium-like tissue occurs beyond the uterine cavity. Tubal endometriosis is an unusual presentation characterised by endometrial glands and stroma within the fallopian tube, most often detected incidentally. It is generally asymptomatic but may cause pelvic pain or infertility. The exact cause of the condition still remains unclear. The objective is to evaluate the clinico-pathological features of isolated fallopian tube endometriosis in hysterectomy and salpingectomy/salpingo-oophorectomy specimens received for benign gynaecological disorders. Materials and Methods: Hysterectomy specimens with bilateral salpingectomy or salpingo-oophorectomy received for benign gynaecological disorders at a tertiary care centre were evaluated. The fallopian tubes were examined on haematoxylin and eosin-stained sections, and immunohistochemistry with CD10 was performed in selected cases for diagnostic confirmation. Results: Fourteen cases of isolated tubal endometriosis were identified in women aged 35–45 years presenting with pelvic pain, dysmenorrhoea, menorrhagia, or heavy menstrual bleeding. Endometrial glands and stroma were confined to the mucosal lining of one or both fallopian tubes, consistent with mucosal or intraluminal tubal endometriosis, without gross abnormality or ovarian or peritoneal involvement. Associated findings included hydrosalpinx, salpingitis isthmica nodosa, leiomyomas and adenomyosis. Conclusion: Isolated tubal endometriosis is an uncommon, frequently incidental finding that may be under-recognised in routine gynaecological specimens. Careful microscopic evaluation of the fallopian tubes is essential for accurate diagnosis and for understanding its association with reproductive dysfunction. Keywords: Tubal endometriosis, Fallopian tube, Endometrial glands, Hysterectomy, Salpingectomy.